We are well-versed in all aspects of Pulmonary Medicine. Asthma, COPD, Emphysema, Pneumonia, Bronchitis, Pleural Effusions and Lung Cancer diagnoses are routinely taken care of in our office. We evaluate our patients to find the reasons for shortness of breath or Dyspnea. Abnormal chest X-rays and CT scans of the chest (CAT scans) are just one of the reasons that our colleagues consult with us. Interstitial lung diseases, such as sarcoidosis, pulmonary fibrosis, BOOP or cryptogenic organizing pneumonia, are the diffuse disease processes that often cause a more complex evaluation. Pulmonary Nodules or "spots" on the CXR are evaluated by us, in association with our radiology colleagues. We do all of the typical diagnostic procedures needed for diagnoses of diseases, such as thoracentesis, bronchoscopy and Pulmonary Function Tests (PFTs) as well as EBUS and Navigational Bronchoscopy. A number of patients need PFTs done in order to monitor possible toxic effects on their lungs from the medications they take. If our colleagues need us to, we can do serial PFTs for them without further pulmonary consultation, unless requested.
As board-certified Critical Care Physicians, we all work in the Intensive Care Units of local hospitals. We do Medical Critical Care work and have provided Intensivist work for one of our Cardiac Surgeons in the past. Now we work in close consultation with a number of subspecialists, providing care when their patients become critically ill. We place central lines and, Swan-Ganz catheters, and manage respiratory failure with BIPAP and mechanical ventilators,as examples. We work closely with our Cardiac Surgery colleagues if we need to incorporate ECMO for ARDS management. We wean individuals from ventilators when it seems difficult for others to do so. We believe that, in order to provide the best care to our patients, it is essential to work closely with our colleagues and use and coordinate everyone's expertise to improve patient's outcomes. As a matter of fact, "code chill" outcomes (individuals with neurologic injury after ventricular fibrillation cardiac arrest) at our institution remain 15% better than the national average.
Dr. Tricia Gilbert is our board-certified Sleep Specialist. We are all trained in basic sleep medicine and are able to initiate the workup of sleep apnea. Home sleep studies are often necessary to make the diagnosis of these diseases, and CPAP or BIPAP titrations may be used therafter to optimize therapy. Dr. Gilbert reads our studies and coordinates the care of our more complex patients. Dr. Gilbert is available to address a vast array of sleep disorders which include: narcolepsy, circadian rhythm sleep disorders, bruxism (teeth grinding), sleepwalking, sleep eating, night terrors, abnormal movements during sleep and sleep disorders caused by medical or psychiatric conditions.
If you need to be admitted... We are here for you!
Medicine has been changing rapidly over the last few years. It is very possible that your Primary Care Physician no longer goes to the hospital. As a consequence, you may need a HOSPITALIST to take responsibility for your admission.
PICSNJ, as a group, cares for both inpatients and outpatients. If you need admission to Robert Wood Johnson University Hospital or Saint Peter’s University Hospital for pulmonary problems, we will be happy to ensure the continuity of care you deserve as YOUR HOSPITALIST.
Two of us are in the hospitals all day, every weekday. We will coordinate with your Primary Care Physician and your Subspecialists as needed to ensure your best and quickest recovery. In addition, we will provide your Primary Care Physician with your Discharge Summary within 48 hours, to ensure they know exactly what happened while you were in the hospital. This ensures that best quality medicine is provided, with followup with your Primary Care Physician as soon as you can after your hospitalization.
Drs. Schiffman and Belsh wrote the original book on ALS for Clinicians in 1996. The Robert Wood Johnson Neuromuscular and ALS Clinic refers to our group, especially Drs. Harangozo and Hutt, as their primary pulmonologists. Dr Shan Chen is now the Director.
The RWJUH ALS Clinic is the only Amyotrophic Lateral Sclerosis Association certified clinic in the state.
PICSNJ works with the multidisciplinary team headed by Dr. Belsh. We perform pulmonary function studies and provide continuous monitoring and support for our patients and families. Some of our patients are also referred from the Philadelphia and New York City centers. Ms. Sucy Philip is our nurse coordinator for ALS patients.
ALS is a variable disease, and patients experience progression of the disease over an undetermined period of time. Some of our patients develop difficulty with swallowing, as well as breathing. If needed, we work closely with Dr. Satya Kastuar and Dr. Sudha Nahar for management of gastrointestinal issues as appropriate.
We provide guidance in keeping with the values of our patients and families. Each individual is different and each course of ALS is variable. Our care is based on this premise, and we strive to keep the best quality of life for everyone involved in this difficult disease process.
We are all Board Certified in Internal Medicine and, as Critical Care Physicians, we are all well-versed in the many aspects of Internal Medicine. Because we are specialists in Pulmonary and Critical Care medicine, patients need to maintain their affiliation with their Primary Care Physician. On occasion, we are the primary caregiver — the "patient home" — to our patients when their major disability is related to our specialty. We appreciate the limitation with end-stage COPD, emphysema, and ALS, and want to maintain your quality of life. As discussed above, we can be your Hospitalist should your Primary Physician not admit to the hospital if your problem is Pulmonary. We are happy to coordinate with them on your care and ensure that you are returned to their care upon discharge.
All PICSNJ's physicians are Volunteer Faculty of Rutgers Robert Wood Johnson Medical School. We have all participated in various ways of teaching medical students, residents from many of the specialties of the school, and pulmonary fellows coming through the program. We also rotate the performance of teaching rounds in the MICU of RWJUH. In addition, our doctors and staff have taught college students, physician assistant students, advanced practice nursing students, and medical assistant students.
